Appliance for setting and bandaging forearm fractures



Jan. 12, 1937. GRUCA 2,067,567

APPLIANCE FOR SETTING AND BANDAGING FOREARM FRACTURES Filed June 12;1935 Ada m r'wm 2, XM. Alto what.

Patented Jan. 12, 1937 UETED STATES PATENT OFFICE Adam Gruca, Lwow,Poland Application June 12, 1935, Serial No. 26,257 In Germany March 22,1935 3 Claims.

Forearm fractures have hitherto been set by two operators, one operatorpulling the broken forearm either directly by the fingers or indirectlyby means of a sling, and the other operator holding the elbow or tyingthe elbow to a stationary support. It is also known to put a steel wirebetween the finger bones of the hand of the patient or around the lowerend of the forearm bones, and connect the wire to a yoke connected witha pulling appliance. The first-mentioned method is very painful to thepatient and fatiguing to the operators. Moreover, the method is notsatisfactory as the broken bones may be accidentally displacedrelatively to each other upon the pull exerted by the operators beingrelaxed or discontinued owing to fatigue. The second-mentioned methodconstitutes a surgical operation which, owing to the unavoidableinfliction of a wound, may have unpleasant consequences and can becarried out only under narcosis or with the aid of a local anaesthetic.Mechanical appliances hitherto proposed for exerting the requiredpulling action have been very little used in practice, owing to theirstructural imperfections. The known appliances are not suitable forfixing exactly the forearm or they are so painful to the patient thatthey cannot be used even under narcosis or with the aid of a localanaesthetic.

The subject of the present invention is an appliance for setting andbandaging forearm fractures which avoids the above-mentioned drawbacks.The invention provides for pulling or stretching the forearm by grippingthe joined fingers of the hand in a manner which is quite free from painto the patient, so that the improved appliance may be employed withnarcosis or a local anaesthetic. A considerable pulling force can beexerted by the improved appliance in a direction which can be exactlydetermined in accordance with the requirements of the case. Moreover,the direction of the pulling force and the magnitude of the force may becontrolled and adjusted in all planes. The fractured arm remains quitefree and is perfectly accessible for the application of gypsoplasticdressing or other bandages.

An important feature of the invention consists in that the improvedappliance comprises a device for fixing the elbow and an adjustable pulldevice acting upon the joined fingers, the two devices being adapted tobe clamped or otherwise fixed to any suitable support, for instance, anordinary table, a bed, an operating table or the like. The drawingdevice comprises, according to the invention, means for clamping thefingers of the patients hand which are pivoted to a yoke-shaped arcuatemember and are fixable relatively thereto in any adjusted angularposition. The pull is exerted by means of a nut and screw device, thescrew spindle of which is connected to the arcuate yoke-shaped member bymeans of a ball joint adapted to be clamped and fixed in any adjustedposition by means of a screw, and by means of an adjustable jointbetween the arcuate yoke-shaped member and the ball joint. Thisadjustable connection permits of an adjustment of the arcuateyoke-shaped member in the plane of the member and approximately aboutthe centre of the arcuate portion of the yoke. The device for clampingand gripping the fingers comprises a first gripping member made, forinstance, of aluminium or other suitable material and shaped inaccordance with the inner surface of the joined second to fifth fingersof the hand, and a second gripping or clamping member which bears uponthe outer surface of the fingers, is bent in accordance with the shapeof the fingers, is provided with a soft rubber plate lining, and ispressed against the outer surface of the fingers by any suitable device,for instance, by means of two screws. The device for fixing the elbowwhich is separate from the device gripping the fingers, preferablyconsists of a supporting'arm which is mounted upon and fixable to avertical rod. The supporting arm preferably carries at the end avertical rod which holds the upper arm. When a gypsoplastic bandage isapplied after the setting operation, the supporting arm, together withthe Vertical rod carried by the supporting arm, can be slid upwards uponthe vertical rod carrying the supporting arm, and both the supportingarm and the vertical rod carried. thereby can then be removed from thebandage by pulling first the supporting arm and then the rod from thebandage.

One constructional form of the invention is shown in the accompanyingdrawing by way of example.

Fig. 1 is a top view of the complete appliance in use,

Fig. 2 is a perspective view of the finger gripping device and theyoke-shaped member attached thereto,

Fig. 3 shows in end elevation and partly in section, the joints betweenthe yoke-shaped member and the pulling device,

Fig. 4 is an elevation partly in section, and

" with considerable and adjustable force by means the bolt22 isspherically shaped and is acted Fig. 5 a corresponding top view of theelbowfixing device,

Fig. 6 is a section on line AA of Fig. 2, and

Fig. '7 a section on line B-B of Fig. 3.

The appliance comprises two separate parts which are adapted to beclamped in the required position upon a suitable support, for instance,upon a table 5 (Fig. 1). The means for fixing and holding theelbow'comprises a vertical rod 4 which is'connected with a fixing orclamping plate 5. Upon the rod 4 (Figs. 1, 4 and 5) is slidably mounteda horizontal arm 3 which is locked against rotation by .a pin 4'. Thesupporting arm 3 rests upon' a collar of the rod 4. Upon the somewhatreduced end portion 3 of the flat supporting arm 3 can be slid anauxiliary support 2 in such a manner that the suitably shaped tubularportion 2' of this auxiliary support encloses the end portion 3'. Whenusing the appliance, the arm I (Fig. 1) of the patient is so insertedbetween the rod 4 and the auxiliary support 2, that the latter bearsagainst the upper arm and the rod 4 forms a good support for the elbowjoint. The forearm to be treated is in this manner freely accessible andmay be rested by the patient upon a suitable padded support 3 in suchamanner that the patient does not feel any fatigue.

The draw device which forms the second part of the appliance is mountedupon a second fixing or. clamping plate 5' which may be clamped in knownmanner to the edge of the table. The drawv device. comprises a sleeve 25connected with the clamping plate and a screw spindle 24, 24" mounted inthe sleeve 25 and adapted to be drawn of a nut operable by means of .ahand wheel 28. The sleeve 25 is secured to the clamping plate 5 by meansof a vertical rod of circular cross section, not shown in detail butindicated by a dotted circle in Fig. 1. The screw spindle 24 isconnected by means of a threaded end portion 24' (Fig. 3) with a tubularsleeve 2|, the other end of which is somewhat reduced in diameter andcontains the ball shaped end portion 29' of a clamp 20 which latter isconnected to the yoke I. The ball shaped end 20 rests against thereduced open end of the sleeve 2| and is pressed against that end bymeans of a bolt 22 having a head 22 bearing upon the ball shaped end20'. The other end of upon by the conical end of a set screw 23 mountedin a thickened portion 24" of the spindle 24. By turning the screw 23,pressure is exerted upon thehead 22 and the latter is pressed againstthe ball 20' whereby the clamp 26 may be fixed in any adjusted angularposition.

The clamp 20 is formed with a fork 20" between the limbs of which can beclamped the yoke I (Fig, 2) of the finger clamping device, by means of aclamping screw l9, l9. The clamping screw passes through a hole in oneof the limbs and has a threaded portion engaging a thread hole in theother limb.

The yoke l which is clamped between the limbs 2c" (Figs. 2 and 6) has anarcuate shape and has ends '1' twisted through 90 with regard to theplane of the main portion of the yoke. These ends Tare provided withholes through which are passed the ends of the rod H carrying the fingergrip member in. The finger grip I is preferably made 'of cast metal, forinstance, aluminium, in such a manner that it conforms exactly to thespace between the joined fingers II-V. This cast metal member may, forinstance, be made to conform to a model made of clay, by putting a pieceof clay into the hand of the patient and compressing the clay by joiningthe fingers and closing the hand. In this manner, recesses are formed inthe finger grip l0 which conform exactly to the individual fingers ofthe patient. The rod H which inwardly supports the finger grip it isprovided at the ends with two threaded tubular members I 2, l2 throughwhich are passed screws 6, 6 provided at their ends with wing heads andcollars 6". Upon the screw bolts 6 slides, by means of end holes IT, afinger clamping plate E8, the ends of which are provided with Washers16, H. The plate 58 is again curved or shaped to conform with the formof the fingers. It is provided with a lining 8 of soft rubber in ordertosoften the pressure upon the fingers.

The ends 9 and I5 of the supporting rod H are turnably mounted inopenings of the ends 'I of the yoke 7. One of the yoke ends I isprovided with a toothed projection cooperating with a correspondingtoothed projection l3 of the adjacent end of the plate H and thecorresponding end l5 of the rod H is threaded and provided with a wingnut 14 so that by turning the wing nut l4, the rod 1 l, and consequentlyalso the finger grip it}, may be fixed in any angular adjusted positionwith regard to the yoke 1.

The mode of using the described appliance is as follows:

After loosening the clamp I9, the finger clamping device, together withthe yoke, is removed from the draw device, the fingers are placed roundthe grip Ill and are clamped by turning the winged head 6. placed uponthe arms 3 and the rod 4 and auxiliary support 2 are suitably adjusted.The yoke I is now inserted into the clamp 19, 2'0", whereupon by turningthe wheel 25, the screw spindle'24, 24 is pulled and the forearm isstretched between the support 2, 3, 4 and the finger clamping device l0,l8, the arm remaining quite free between the support and the drawdevice.

If, during the operation, the direction of the draw needs to be alteredat right angles to the plane of the hand, the ball 20' is released byloosening the screw 23, whereupon the hand may be suitably adjusted andthe screw 23 screwed home. If, on the other hand, it is desiredtoincrease the draw action in the direction of the elbow, the screw I9is loosened and the yoke l is adjusted in the required direction. Thedirection of turning is regulated by means of the clamp 23.

After the forearm fracture has been set and a fixed bandage has beenapplied, the fingers are first released from the clamping device [8,ll], whereupon the whole forearm is slid upwardly parallel to itsoriginal position, the. support 3 with the counter support 2 upon therod 4 being moved upon the rod 4 upwardly and remaining in the plasteror other mass. By pulling in the longitudinal direction of the support,the latter can be withdrawn from the plaster, as well as subsequentlythe auxiliary support 2 which is likewise withdrawn in the longitudinaldirection. The operation may be performed with the patient being eitherseated or lying down.

I claim:

1. Appliance for setting and bandaging forearm fractures comprising:means for supporting and fixing the elbow; means for gripping thefingers, and a draw device connected with said gripping means; a commonsupport for said draw device and said elbow fixing means, both the Theelbow is then elbow fixing means and the draw device being independentlyadjustable upon the common support, said draw device comprising anarcuate yoke pivoted to said finger gripping means; means for fixingsaid arcuate yoke after adjustment relatively to said finger grippingmeans; a screw and nut device; a ball joint at the end of the screw;means for clamping said ball joint in an adjusted position; and aclamping device connected to said ball joint for connecting the arouateyoke, said arcuate yoke being slidable in said clamping device foradjustment.

2. Appliance for setting and bandaging forearm fractures comprising:means for supporting and fixing the elbow; means for gripping thefingers, and a draw device connected with said gripping means; a commonsupport for said draw device and said elbow fixing means, both the elbowfixing means and the draw device being independently adjustable upon thecommon support, said finger gripping device comprising an inner fingerplate to be gripped by the fingers and an outer plate; and screw meansfor fixing the outer plate to the inner plate, both the inner and theouter plate being shaped to conform with the shape of the fingers.

3. Appliance for setting and bandaging forearm fractures comprising:means for supporting and fixing the elbow; means for gripping thefingers, and a draw device connected with said gripping means; a commonsupport for said draw device and said elbow fixing means, both the elbowfixing means and the draw device being independently adjustable upon thecommon support, said elbow fixing device comprising a fixed verticalrod; a horizonal arm slidable upon said rod and fixable thereto; and anauxiliary rod detachably mounted upon said arm, said horizontal armbeing removable from said fixed rod by sliding upwardly and saidauxiliary rod being removable from said arm by sliding horizontally.

ADAM GRUCA.

